Drug Efficacy

I had lunch with my mother yesterday, and we were talking about my grandfather, who has in the past had prostate cancer and recently learned he had a cancerous mass in one of his kidneys. He had the kidney removed last week, but he was still feeling a little under the weather and had developed a fever, so the doctor prescribed antibiotics and stressed how important it was for him to take them with food so they absorbed effectively, now that his remaining kidney has an extra burden of absorption.

At this point in the conversation, I realized I hadn't taken any vitamins, and I pulled out the little baggie of 19 pills I'd brought with me. I told my mom about the vitamin and herb cocktail I'd started, and she joked, "Why are you taking all that? To make really expensive pee?"

We laughed, and I explained how I have been careful to always take them with food and spread them out through the day so they can be absorbed properly. She insisted that the body doesn't absorb supplements and a person just pees them out.

While I disagree with my mother and wonder where she got her cynicism from, it did give me momentary pause. How do I know any of this is doing anything?

With prescription drugs, even if they weren't achieving their intended effects, I was sure the drug was getting into my system because I felt so completely different in every way when I took them. If I took my antidepressant a little late in the day, there was a noticeable difference, and if I missed a day, I would faint. Two days, and I had a seizure. (This is part of the reason I'm leery of psychopharmaceuticals - I don't like something having so much control over my entire body).

However, with herbal supplements and vitamins, I'm less sure. I like that ginseng doesn't make me feel like I'm on speed, but I wonder if it really boosts my energy. I feel like I'm concentrating a little better with ginkgo biloba, but I can't say for sure that I have better circulation to my head and extremities because I don't feel gushes of blood and all that. And similarly with my One-a-Day, I feel a little better all over, but I can't say what vitamins are helping which processes.

For the first two years of my undergrad, I majored in Neuroscience, and probably my favorite class was Neuropathology. In the pharmacology unit, we studied specific drugs and why they did what they did at a molecular level, then expanded it to understand what happened on cellular, systemic, bodily, and psychiatric levels. Because I could say exactly what the drug molecules did in the brain, I could believe that they had the effects they were supposed to, and I understood how to monitor a patient's treatment.

I don't have that kind of knowledge of vitamins and herbs, and I'm not 100% confident that the people who harvest and package herbs do either. Yes, the history of pharmacology is one of adapting substances from nature with observed effects to controlled and standardized units packaged in pills, powders, and the like, and marketed as cures. But how do we know what they do? Is it okay to simply say ginseng gives you energy, just like caffeine or cocaine, and I don't have to question how and why? I want to research these further and understand them at a chemical level before I put all my faith in them.

For now I have chosen to trust these pills and see what they do. I'm not so naive as to say anything from nature can't be bad for me, but I trust the amount of research that's been done in the three herbal drugs I'm taking, as well as the efficacy of a multivitamin and vitamin C in maintaining a healthy immune system.

I would really appreciate it if anyone could point me in the direction of some more concrete data on St John's Wort, Koren ginseng, and Ginkgo Biloba. And if you have anything on chromium picolinate, I'm all ears for that too.

New Cocktail

I've had some pretty hugely stressful things go on in my life since last writing (terrible family scare, really important school deadlines, near break-up with my boyfriend etc), but I think I'm past it now.

The diet went out the window as I put all my priorities into school. I gained back all the weight I'd lost in Italy plus some, and the overall shape of my body is much worse now that I am not exercising so regularly. My clothes fit poorly, I cringe at photos of myself with shock, and all that.

I wasn't too concerned because I can accept that weight loss is a long and slow process. Where I was worried is the ways in which being physically unhealthy was affecting my mental and emotional health. I got into a rather terrible spiral of anxiety and depression that I wasn't sure how to get out of. Finishing a major project helped, but I still could tell that my moods were imbalanced and I wasn't really myself.

Last week, my boyfriend and I went out with friends, and my mood was finally starting to lift. We had a few drinks, but I limited myself to three whiskey drinks, the last one mixed with a 12-oz can of Diet Coke.

I'm hesitant to write this even as I do because even though this journal is anonymous, it's still really really embarrassing. Here goes.

When we got in the elevator, I realized I had to pee, fairly urgently. As long as we kept walking, I was alright, but by the time I had to stop to pay for my Metro card, I really didn't know how I was going to keep myself together. I was wearing heeled boots, and as I carefully started down the stairs, one of them caught on a step, I started to slip, and I thought I was going to fall. I caught myself, but I was so startled that I'd lost control of my bladder and ended up... wetting my pants on the subway platform.

Fortunately I had a shopping bag in front of me and a scarf to tie around my waist, but I was absolutely mortified.

When I got home, I showered, then immediately went onto WebMD. See, I've always had really sudden urges and needed to pee many times a day (up to once or twice an hour), but I figured it was an excess of caffeine or attention issues (I get really involved in what I'm doing and don't realize I must go until it's nearly an emergency). I had been having more and more close calls prior to the subway, so I'd cut back on soda, but I never felt quite so... incontinent before.

The first article I came across was one to do with the 3 Conditions Women Don't Talk About, and they were incontinence, irritable bowel syndrome, and waning sexual desire. Check, check, and (I have to admit), check.

I read up on all three, and I decided it was time to take matters into my own hands. Before going on Zoloft a few years ago, I'd spoken with my doctor about herbal alternatives, specifically St John's Wort. She said they were just as effective if not better than the prescription, but they could be difficult to monitor and basically required that you be on a steady diet and exercise regime for them to work, as they were supplements to a healthy lifestyle, and not replacements for one. Being lazy and immature, I opted for prescriptions and went through a year of hell and irresponsible psychiatry, never quite getting the doses right.

So last week I decided that rather than see another psychiatrist, whose primary resource is a prescription pad, I would take up a healthier lifestyle, monitor myself through writing, and take herbal supplements. The fact that my insurance doesn't cover prescriptions or counseling was probably in the back of my mind, but it seemed like the better way to treat my body.

I realized today that I now take a lot of pills every day, instead of one little one, but I think overall they're better:



From left to right: St John's Wort, Korean ginseng, good old One-a-Day WeightSmart, Ginkgo Biloba, vitamin C, chromium picolinate, and fiber supplements.

I started taking them on Monday, and so far I feel terrific. I know that it is probably a bit of a placebo effect, since the St John's Wort is supposed to work slowly over two months, but I can immediately feel an increase in energy and enthusiasm. I'm just generally cheerier, and I'm optimistic that I'm on the right path to helping myself naturally.

I need to start back up on a diet again. My boyfriend wants to go back on Atkins, but I'm thinking that the Glycemic Impact would be better for us as far as a long-term lifestyle change.

My boyfriend and I have also been talking a lot about our behaviors and what we do to one another. We fight all the time about the apartment being a disaster (and yes, it really is that bad), and generally our relationship had deteriorated to one of constant bickering and shouting. I finally decided in the midst of a really ugly fight that that was enough. I insisted that if we were going to have anything to do with one another (at this point, he said he was moving out and I said I was through with him), we needed some ground rules, namely no yelling, no name-calling, berating or character assaults, no slamming doors or storming out in anger, and our conversations should have one topic or point per statement, no making speeches or litanies of offenses. It's been going a lot better since then, and we've been considerably kinder to one another.

I feel that if we work to get our living situation more comfortable and productive for both of us, then it will be a lot easier to stick with a diet and exercise plan (and vice versa). To the same extent that my poor health was affecting my moods and concentration, I know that our mutual physical problems are really negatively impacting our relationship. So it's time to change.

While I am rambling excessively about my health (it's been a while, I have to catch up!), I also have two other issues I want to keep an eye on.

1.) My vision is getting noticeably worse, to the point where my glasses are barely working on some days. I'm not sure if it is eye fatigue and need of a new prescription (as the dull headaches would indicate) or overall bleary-eyed tiredness (as the early morning classes are a strain sometimes), but I want to get it checked out, if I can find somewhere affordable. It really irks me that my school's insurance doesn't cover dental or vision at all, as if graduate students no longer have teeth or eyes when they enroll. Nevertheless, if I can justify spending money on shoes or jeans, I can definitely find some room in my budget to take care of my vision.

2.) Skin and hair. My skin seems to be breaking out worse than usual, probably from stress, anxiety, and poor nutrition. I have some new products I'm introducing into my regime, so we'll see. I've been concerned about my hair thinning for a few years now, as it was a big side effect of anxiety, then Zoloft, then anxiety again. I keep going through shampoos trying to find one which works best, but I'm still dissatisfied. It's my hope that better nutrition and exercise, as well as alleviating some anxiety will help, but I want to pay attention. I also want to be careful that whatever diet I choose still gets enough good fats and oils to maintain healthy hair and skin.

So, that's the current state of my health and life. Whew. Back to schoolwork!